GRO35 Required Forms Final~1.docx

FORM CHECKLIST

GRO35 Foodservice Supplies and Equipment Institutional Commercial Grade, Large and Small

Listed below are the required forms that must be submitted with the bid response for award consideration - please check off completed forms

· Prompt Pay Discount Form (PPD) (mandatory requirement MUST offer PPD)

· SDP Plan Form #1 - Plan Commitment

· SDP Plan Form #2 - Declaration of SDP Partner(s)

· Business Reference Form

· Business Reference Letters with reference form

· Additional Environmentally Preferable Products/Practices

· Certificate of Non-Collusion

· Commonwealth of Massachusetts - Certificate of Good Standings

COMMONWEALTH OF MASSACHUSETTS

Prompt Pay Discount Form (Invoice discounts for receiving fast payments)

Revised 3/9/07 Bidder Name: .

Vendor Code (VCUST): .

Contract/RFR Number(s): GRO35 Foodservices Supplies & Equipment

Prompt Payment Discounts (PPD). All contractors/vendors doing business with the Commonwealth must provide a Prompt Payment Discount (PPD) for receiving early payments unless the Contractor/vendor can provide compelling proof that providing a prompt pay discount would be unduly burdensome. Contractors benefit from PPD by increased, usable cash flow as a result of fast and efficient payments for commodities or services rendered. Contractors who agree to accept Electronic Funds Transfer (EFT) increase the prompt pay benefit by ensuring that funds are paid directly to their designated bank accounts, thus eliminating the delay of check clearance policies and traditional mail lead time. Payments processed through the state accounting system (MMARS) can be tracked and verified through the Comptroller’s Vendor Web system using the Vendor/Customer Code assigned to you by a Commonwealth department.

The Commonwealth benefits because contractors reduce the cost of products and services through the applied discount. While Bidders/Contractors have flexibility in determining the actual % discount(s) offered to the Commonwealth, the discount(s) must be identified for 10, 15, 20 and/or 30 days for payment issuance in the column entitled “% Discount Off Proposed Price” below. The Commonwealth may use the prompt pay discounts submitted as a basis for selection and may negotiate discounts as deemed in the best interest of the Commonwealth. The requirement to offer PPD discounts may be waived by the Commonwealth on a case-by-case basis if participation in the program would be unduly burdensome, provided the specific reason for the hardship is outlined below.

All discounts offered will be taken in cases where the payment issue date is within the specified number of days listed below and in accordance with the Commonwealth’s Bill Paying Policy. Payment days will be measured from the date goods are received and accepted / performance was completed OR the date an invoice is received by the Commonwealth, whichever is later to the date the payment is issued as an EFT (preferred method) or mailed by the State Treasurer. The date of payment “issue” is the date a payment is considered “paid” not the date a payment is “received” by a Contractor.

If internal Bidder/Contractor systems require an alternate method of measuring payment issue dates, the Bidder/Contractor must note the issues below or on an attached page if necessary to be considered by the PMT. In cases where the Bidder/Contractor considers that offering a Prompt Payment Discount would be a hardship, the Bidder must clearly define the issues and reasons for said hardship. Providing volume discounts or other discounts on prices is not considered a hardship, since the PPD provides the additional benefit of early cash flow for the Contractor.

Enter the Prompt Payment Discount percentage (%) off the invoice payment, for each of the payment issue dates listed, if the payment is issued within the specified Payment Issue days. For example:

5% - 10 Days 4% - 15 Days 3% - 20 Days 2% - 30 Days If no discount is offered enter 0%

The Contractor is unable to provide a prompt payment discount due to the following hardship:

Contractor/Bidder Authorized Signature _________________________________ Date: ____________

Contractor/ Bidder Authorized Signatory Print Name and Title: __________________________________ Supplier Diversity Program (SDP) Plan Commitment SDP Plan Form #1 (To be submitted with Bid Response)

Contract/RFR Document Number: GRO35

Instructions: Completing all parts of this form is mandatory. Please read instructions in the SDP section of the solicitation. Complete one form and submit with Bid.

Part I Bidder/Contractor Information (Required)

Business Name:

Contact Name:

Part II Financial Commitment (Required)

Provide a specific percentage committed (as a percentage of Bidder/Contractor sales derived from this contract for the life of the contract) to be spent with all certified SDP Partners that the Bidder will propose if awarded a Contract. Please note that prime bidders who are SDO-certified must also submit an SDP Plan Form.

Supplier Diversity Program (SDP) Resources:

· Resources available to assist Prime Bidders in finding potential Minority Business Enterprises (MBE) and Women Business Enterprises (WBE) partners can be found on the Supplier Diversity Program Webpage (www.mass.gov/sdp).

· Resources available to assist Prime Bidders in finding potential Service-Disabled Veteran-Owned Business Enterprise (SDVOBE) partners can be found on the Supplier Diversity Office Webpage (www.mass.gov/sdo).

· The Supplier Diversity Program offers training on the SDP Plan requirements. The dates of upcoming trainings can be found on the OSD Training & Outreach Webpage. In addition, the SDP Webinar can be located on the Supplier Diversity Program Webpage (www.mass.gov/sdp).

Supplier Diversity Program (SDP) Plan - Declaration of SDP Partner(s) SDP Plan Form #2 (Must be submitted by Contractor within a period of up to 30 days (or as stated in RFR) of Contract Execution) Contract/RFR Document Number: GRO35

Instructions: Completing all parts of this form is mandatory. Please read instructions in the SDP section of the solicitation. Complete one form and submit within a period of up to 30 days (or as stated in RFR) of Contract Execution. See SDP and SDVOBE Resource information below to assist in partnering with certified businesses.

Part I Contractor Information (Required)

Please note that prime bidders who are SDO-certified must also submit an SDP Plan Form and may not list themselves as an SDP Partner. Check any of the following that are applicable to the Bidder:

|_| Minority-owned Business Enterprise (MBE); Certification Expiration Date (If applicable): / / |_| Women-owned Business Enterprise (WBE); Certification Expiration Date (If applicable): / / |_| Non-Profit Organization (NPO); Certification Expiration Date (If applicable): / / |_| Service-Disabled Veteran-owned Business Enterprise (SDVOBE); Certification Expiration Date (If applicable): / /

Identify Business Opportunities for SDP Partners (Optional):

Part II Contractor’s SDP Partners (Required) (Fill in Applicable Lines; Insert Additional Rows as Needed)

Planned SDP Partner’s Company Name

|_| WBE

|_| MNPO/WNPO/MWNPO

|_| SDVOBE

|_| WBE

|_| MNPO/WNPO/M/WNPO

|_| SDVOBE

|_| WBE

|_| MNPO/WNPO/MWNPO

|_| SDVOBE

|_| WBE

|_| MNPO/WNPO/M/WNPO

|_| SDVOBE

Part III Under the pains and penalties of perjury I certify that the information provided on this form is accurate. (Required)

(May be left blank if submitted electronically) Date: / /

*The Supplier Diversity Office and contracting Department reserve the right to contact SDP Partners at any time to request that they attest to the amounts reported to have been paid to them by the Contractor.

** SDP Partner Certification Acronyms: MBE = Minority-owned Business Enterprise; WBE = Women-owned Business Enterprise; SDVOBE = Service-Disabled Veteran-owned Business Enterprise.

*** Certification Status can be checked on the Supplier Diversity Program Webpage (www.mass.gov/sdp).

Supplier Diversity Program (SDP) Resources:

· Resources available to assist Prime Bidders in finding potential Minority Business Enterprises (MBE) and Women Business Enterprises (WBE) partners can be found on the Supplier Diversity Program Webpage (www.mass.gov/sdp).

· Resources available to assist Prime Bidders in finding potential Service-Disabled Veteran-Owned Business Enterprise (SDVOBE) partners can be found on the Supplier Diversity Office Webpage (www.mass.gov/sdo).

· The Supplier Diversity Program offers training on the SDP Plan requirements. The dates of upcoming trainings can be found on the OSD Training & Outreach Webpage. In addition, the SDP Webinar can be located on the Supplier Diversity Program Webpage (www.mass.gov/sdp).

BUSINESS REFERENCE FORM

Bidder: _______________________________________________________ RFR Name/Title: Foodservice Supplies & Equipment RFR Number: GRO35 The bidder must provide three (3) business references on this form and three (3) letters of references must be submitted with bid response.

Reference name:_____________________________________ Contact:

Address: _________________________________________Phone: # ( ) Fax/Internet address:

Description and date(s) of commodities and services provided:

Reference name: _______________________________________Contact:

Address: _________________________________________Phone: # ( ) Fax/Internet address:

Description and date(s) of commodities and services provided:

Reference name: ______________________________________ Contact:

Address: __________________________________________Phone: # ( ) Fax/Internet address:

Description and date(s) of commodities and services provided:

References will be contacted to confirm the bidder’s abilities and qualifications as stated in the bidder’s response. The department may deem the bidder’s response unresponsive if a reference is not obtainable from a listed reference after reasonable attempts.

ADDITIONAL ENVIRONMENTALLY PREFERABLE PRODUCTS / PRACTICES

Bidder Company Name: ___________________________________________________ Date: _______________ In line with the Commonwealth’s efforts to promote products and practices which reduce our impact on the environment and human health, Bidders are encouraged provide information regarding their environmentally preferable/sustainable business practices as they relate to this contract wherever possible. Bidders who can demonstrate such initiatives (referencing, but not limited to, the items listed below) will be eligible to receive evaluation points. In order to receive evaluation points, Bidders must complete this form and submit it with their RFR Response.

Bidders must submit appropriate documentation to support the items for which the Bidder indicated a “Yes” (and/or include information in the box following each question). NOTE: If bidder is referencing an annual environmental report, page numbers must be specified for referenced information in order to receive points.

NOTE: Please see page 2 for additional guidance on completing this form.

1. Packaging Has the Bidder implemented any of the following environmental initiatives? (A checkmark indicates “Yes”)

packaging take-back services, or shipping carton return

If checked, documentation of specific practices must be included in the box below, which will expand to accommodate your response.

2. Business Practices / Operations / Manufacturing Does the bidder engage in practices that serve to reduce or minimize an impact to the environment, including, but not necessarily limited to, the following items?

If checked, documentation of practices must be included in the box below, which will expand to accommodate your response.

3. Training and Education Does the bidder conduct/offer programs to train or inform:

If checked, bidders must attach a description of the training offered and the specific criteria targeted by the training in the box below which will expand to accommodate your response.

4. Certifications Has the bidder or any of its manufacturers and/or subcontractors obtained any of the following product/industry certifications?

Certification, C2C Protocol, Responsible Care Codes of Practice or other similar standards ____ Third Party product certifications such as Green Seal, Scientific Certification Systems, Smartwood, etc.

If checked, bidders must indicate certificate name in the box below and attach a (scanned) copy with their response.

5. Other Environmental Criteria Bidders are encouraged to respond to criteria specifically indicated in this RFR as “desirable environmental criteria” to receive consideration in the evaluation. (Please provide information in the box below)

GUIDANCE ON COMPLETING THE

ADDITIONAL ENVIRONMENTALLY PREFERABLE PRODUCTS/PRACTICES FORM

This is a standard evaluation tool included with virtually all OSD Requests for Response (RFR) that will result in a Statewide Contract. It specifically applies to the operations of the Bidder (not any manufacturer or other company represented buy the Bidder).

Purpose of the Form:

1) The primary purpose for incorporating this language into RFRs is to encourage potential Bidders to adopt business practices that foster a sustainable approach to conducting their operations. This may include approaches that have reduced impact on the environment or public health, such as, but not limited to, creating less waste by using less packaging; eliminating the use substances and/or materials that are considered toxic during the manufacturing process, at time of product use, or upon disposal; or using vehicles in the delivery fleet that operates on alternative fuels for the purpose of reducing air pollution and greenhouse gas emissions.

2) The form alerts Bidders that the Commonwealth considers such initiatives part of the “best value” of a procurement.

3) The form provides Bidders with an opportunity to receive “preference” in the evaluation phase of the RFR for the environmental initiatives they have instituted. It is important for Bidders to provide a statement (or other documentation) along with their response to substantiate or better explain how those initiatives are implemented in their operations in order to receive a preference or points.

Guidance on Completing the Form

1) Packaging – Many forms of corrugated containers now contain 60% or more post-consumer recycled content and are comparable in cost; in addition, several alternatives to using polystyrene as a packaging cushion are now available. Bidders should check with their box manufacturers to learn about the recycled content they use and include information about that in their RFR Response. Companies are also encouraged to research the EPP alternative products and practices indicated on the form and convert to their use wherever possible.

2) Business Operations – This section refers to things the Bidder does within their own operations to create a smaller “environmental footprint” in the marketplace by reducing the impact of their operations through energy conservation, waste and toxics reduction and other sustainable practices.

3) Training and Education – If Bidders offer a product or service that involves an environmentally preferable component and they train their staff to inform customers of these features, such training should be mentioned in conjunction with this form to receive credit. If Bidders provide materials (brochures, info on websites, etc.) on the environmental attributes of their products/services, they can also receive credit in the evaluation process if a brief explanation is included with the form. It is preferable if such training materials and other information are included with the Response.

4) Certifications – Bidders should familiarize themselves with the various certifications for products and processes that are available within the industry in which they operate, with particular attention to those concerning environmental issues. Providing information with the EPP form on such certifications and/or attaching a copy of the actual certificate is important to receive credit in the evaluation process.

5) Other Environmental Criteria – If Bidders are already doing something indicated in the RFR as a “desirable” criteria and they include a statement with their RFR that they have implemented such measures, this will be considered in the evaluation phase as well. In addition, any initiative untaken by the Bidder that may be considered an environmental benefit should be mentioned as part of this section in the RFR.

Non-Collusion Certificate: Attached to this RFR is a Non-Collusion Certificate. By signing the attached Non-Collusion statement, the bidder is declaring that their bid response was formulated without collusion with any person, representative, agent or party submitting competing proposal or bid. No proposal or bid will be accepted without the signed Non-Collusion statement attached to their response.

CERTIFICATE OF NON-COLLUSION

The undersigned certifies under the penalties of perjury that this bid or proposal has been made and submitted in good faith and without collusion or fraud with any other person. As used in this Certificate, the word “person” shall mean any natural person, business, partnership, corporation, union, committee, club or other organization, entity or group of individuals.

Signature/date

Print Name

Name of Business

Certificate of Good Standing

Bidders will be required to submit with their bid response a Certificate of Good Standing as stated below:

Corporations and other organizations often need proof that they are in good standing with the Commonwealth, i.e., that all tax liabilities have been met in order to obtain financing, sell their business, renew licenses or enter into other business transactions.

The fastest and easiest way to obtain a Certificate is via our online application. Both taxpayers and authorized practitioners can use this program to obtain a Certificate within a few days. Before beginning this process, make sure that key authenticating data is readily available, including the entity's id number, a list of tax types filed with DOR and the dates when the entity was first required to collect and submit these taxes.

Once the applicant has been authenticated, a search will be made of our databases to identify any returns that need to be filed or bills that remain unpaid. Since this process takes up to 48 hours, users will be given an application number and asked to come back to the program in a couple of days. At that time, fully compliant taxpayers will be able to print a Certificate or request that it be mailed to the address of record. If bills are identified, an opportunity will be given to pay the amount owed via EFW. A Certificate will then be issued. Taxpayers with nonfiled Trustee tax returns (Sales, Meals, Withholding, Room Occupancy), can file and pay within the application and obtain their Certificate. Taxpayers with nonfiled Income and Corporate returns will be given instructions on how to file on paper and obtain a Certificate.

Please note:

Taxpayers responsible for certain taxes such as Alcoholic Beverage Excise, Cigarette Excise, Sales Tax on Boats, International Fuels Tax Agreement, Smokeless Tobacco or Ferry Embarkation will need to file a paper application. This form can be printed from this site. Paper applications can take 4 to 6 weeks.

Paper applications are also required in order to obtain a Waiver of Corporate Tax lien.

Dissolutions: Corporations have not been required to obtain a Certificate of Good Standing prior to a voluntary dissolution since March 1992.

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